pharm HTN crisis

Question 1

htn emergencies

Answer 1

severe elevation >180/120 with end organ damage

Question 2

htn urgency

Answer 2

severe elevation >160/100 no end organ damage

Question 3

treatment goal of htn emergency

Answer 3

lower no more than 25% in the first 30-60 min using iv meds

then goal of less than 160/100 in next 2-3 hours

Question 4

treatment rule exception

Answer 4

aortic dissection - sbp blow 100 if tolerated
stroke patients-must lower for thrombolytics
ishemic stroke ( no evidence to support lowering BP)

Question 5

HTN emergency with acute MI

Answer 5

bblocker with nitroglycerin

Question 6

HTN emergencies with eclampsia

Answer 6

labetalol, nicardipine hydralazine

Question 7

HTN emergency with aortic dissection

Answer 7

Labetalol/esmolol alone or in combo with nicardipine, clevidipine, or nitroprusside

*Bblocker first

Question 8

HTN emergency with acute heart failure

Answer 8

Nitroprusside, nitroglycerin-not for R sided HF, nesiritide, or ACE-I in combo with diuretics if pulmonary edema (Avoid β-blockers)

Question 9

HTN emergency with acute intracerebral hemorrhage/ acute ischemic stroke

Answer 9

labetalol, nicardipine, fenoldopam

Question 10

HTN emergency with acute renal failure

Answer 10

Fenoldopam, *nicardipine, clevidipine

Question 11

HTN urgency

Answer 11

most pts are just non-compliant so give them the meds they were taking before
-treatment is concervative use oral meds

Question 12

treatment of pheochromocytomas

Answer 12

treat with phenoxybenzamine and a β-blocker

Question 13

sodium nitroprusside

Answer 13

never give to kidney failure patients
active part nitric oxide
venodilation to reduce preload

Question 14

fenolopam

Answer 14

rapid acting vasodilator